Physio anatomy.pdf

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THE UNIVERSITY OF MELBOURNE DEPARTMENT OF PHYSIOTHERAPY Independent Learning Guide Phys@tomy FOR Doctor of Physiotherapy Introduction: Welcome to the Doctor of Physiotherapy Program. Phys@tomy is a self directed learning package that has been developed to facilitate student revision and preparation for entry into the Doctor of Physiotherapy Program at the University of Melbourne. The material outlined in this package will form the basis of the theoretical background in Functional Anatomy that will be in part assumed knowledge and will be built upon throughout the graduate program. The material will be presented in a series of modules each of which will have detailed learning objectives that are designed to direct and sequence the learning. It is advised that the student complete each module one at a time prior to moving onto the next. It is recommended that the student take approximately 4 hours to complete each module.

Transcript of Physio anatomy.pdf

Page 1: Physio anatomy.pdf

THE UNIVERSITY OF MELBOURNE

DEPARTMENT OF PHYSIOTHERAPYIndependent Learning Guide

Phys@tomy

FOR

Doctor of Physiotherapy

Introduction:

Welcome to the Doctor of Physiotherapy Program. Phys@tomy is a self directedlearning package that has been developed to facilitate student revision andpreparation for entry into the Doctor of Physiotherapy Program at the Universityof Melbourne.The material outlined in this package will form the basis of the theoreticalbackground in Functional Anatomy that will be in part assumed knowledge andwill be built upon throughout the graduate program. The material will bepresented in a series of modules each of which will have detailed learningobjectives that are designed to direct and sequence the learning.It is advised that the student complete each module one at a time prior to movingonto the next. It is recommended that the student take approximately 4 hours tocomplete each module.

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Modules:

Module 1: Introductory Osteology and ArthrologyModule 2: The Shoulder, Upper Arm and ElbowModule 3: The Forearm, Wrist and HandModule 4: Nerve and Blood Supply of the Upper LimbModule 5: The Pelvis, Hip and KneeModule 6: The Lower Leg and FootModule 7: The Nerve and Blood Supply to the Lower LimbModule 8: The Head and NeckModule 9: The Abdomen and TrunkModule 10: The Heart and Lungs

Learning Objectives

Material in:

x bold print: form the structures that require identification. Ananatomical atlas or model may be used for this purpose

x regular print: form the independent learning questions to be answered

from the recommended texts and lectures provided

x italic blue print: form the quiz questions that are aiming to extend

knowledge into application

x bold orange print: form the surface anatomy objectives

REFERENCESHighly recommended resources to guide your completion of each module:

x Textbook: Moore KL (2006) Clinically Orientated Anatomy (5th ed.)

Baltimore: Lippincott Williams & Wilkins*.

x Atlas: Rohen J, Yokochi C, Lutjen-Drecoll E (2002) Color Atlas ofAnatomy: A Photographic Study of the Human Body. Lippincott, Williams

& Wilkins*

x Web based Materials: Eizenberg N, Briggs C, Barker P & Grkovic I(2010)An@tomedia CD-ROMs: (Available from University Bookshop and

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also available to all students on the computers in the Department of

Physiotherapy computer laboratory) *

Additional references for anatomyIn addition other resources that would be appropriate for completion of thesemodules are:

x Netter FH (2006) Atlas of Human Anatomy (4th ed. (Elsevier)

x Agur A, Dalley F (eds) (2005) Grant's Atlas of Anatomy (12th ed.)Philadelphia : Lippincott Williams & Wilkins

x Schuenke M, Schulte E, Schumacher U (Ross LM & Lamperti ED

Consulting eds). (2006). Thieme. Atlas of Anatomy: General anatomyand musculoskeletal system. Stuttgart, Thieme Publisher

x Oatis CA (2009) Kinesiology: The mechanics and Pathomechanics of

human movement. 2nd ed*x Levangie, P. K. and C. Norkin (2005). Joint Structure and Function:

A Comprehensive Analysis (4th ed). Philadelphia, F.A.Davis.x Neumann, D. (2002). Kinesiology of the Musculoskeletal System.

Foundations for Rehabilitation. St. Louis, Mosbyx Bogduk (2008) Clinical Anatomy of the Lumbar spine & Sacrum (6th

Edn). Churchill Livingstone.

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THE UNIVERSITY OF MELBOURNE

DEPARTMENT OF PHYSIOTHERAPYIndependent Learning Guide

Phys@natomy

FOR

Doctor of Physiotherapy

(Module 1: Introductory Osteology and Arthrology)

Dr Doà El-Ansary, BAppSc(Phty), PhDDr Elizabeth Tully, BAppSc(Phty), Dip Ed, PhD

Page 5: Physio anatomy.pdf

University of MelbourneDoctor of PhysiotherapyIndependent Learning Package in Functional AnatomyDr Doa El-Ansary and Dr Elisabeth Tully

Introduction:

Welcome to the Doctor of Physiotherapy Program. Phys@natomy is a self directedlearning package that has been developed to facilitate student revision andpreparation for entry into the Doctor of Physiotherapy Program at the University ofMelbourne.The material outlined in this package will form the basis of the theoreticalbackground in Functional Anatomy that will be in part assumed knowledge and willbe built upon throughout the graduate program. The material will be presented ina series of modules each of which will have detailed learning objectives that aredesigned to direct and sequence the learning.It is advised that the student complete each module one at a time prior to movingonto the next. It is recommended that the student take approximately 4 hours tocomplete each module.

Modules:

Module 1: Introductory Osteology and ArthrologyModule 2: The Shoulder, Upper Arm and ElbowModule 3: The Forearm, Wrist and HandModule 4: Nerve and Blood Supply of the Upper LimbModule 5: The Hip and KneeModule 6: The Lower Leg and FootModule 7: The Nerve and Blood Supply to the Lower LimbModule 8: The Head and NeckModule 9: The TrunkModule 10: The Heart and Lungs

Learning Objectives

Material in:

x bold print: form the structures that require identification. An anatomicalatlas or model may be used for this purpose

x regular print: form the independent learning questions to be answered from

the recommended texts and lectures provided

x italic blue print: form the quiz questions that are aiming to extend knowledge

into application

x bold orange print: form the surface anatomy objectives

Page 6: Physio anatomy.pdf

University of MelbourneDoctor of PhysiotherapyIndependent Learning Package in Functional AnatomyDr Doa El-Ansary and Dr Elisabeth Tully

REFERENCESHighly recommended resources to guide your completion of each module:

x Textbook: Moore KL (2006) Clinically Orientated Anatomy (5th ed.)

Baltimore: Lippincott Williams & Wilkins*.

x Atlas: Rohen J, Yokochi C, Lutjen-Drecoll E (2002) Color Atlas ofAnatomy: A Photographic Study of the Human Body. Lippincott, Williams &

Wilkins*

x Web based Materials: Eizenberg N, Briggs C, Barker P & Grkovic I(2010)An@tomedia CD-ROMs: (Available from University Bookshop and alsoavailable to all students on the computers in the Department of Physiotherapy

computer laboratory) *

Additional references for anatomyIn addition other resources that would be appropriate for completion of thesemodules are:

x Netter FH (2006) Atlas of Human Anatomy (4th ed. (Elsevier)

x Agur A, Dalley F (eds) (2005) Grant's Atlas of Anatomy (12th ed.)Philadelphia : Lippincott Williams & Wilkins

x Schuenke M, Schulte E, Schumacher U (Ross LM & Lamperti ED Consulting

eds). (2006). Thieme. Atlas of Anatomy: General anatomy andmusculoskeletal system. Stuttgart, Thieme Publisher

x Oatis CA (2009) Kinesiology: The mechanics and Pathomechanics of

human movement. 2nd ed*x Levangie, P. K. and C. Norkin (2005). Joint Structure and Function:

A Comprehensive Analysis (4th ed). Philadelphia, F.A.Davis.x Neumann, D. (2002). Kinesiology of the Musculoskeletal System.

Foundations for Rehabilitation. St. Louis, Mosby

x Bogduk (2008) Clinical Anatomy of the Lumbar spine & Sacrum (6th Edn).

Churchill Livingstone.

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University of MelbourneDoctor of PhysiotherapyIndependent Learning Package in Functional AnatomyDr Doa El-Ansary and Dr Elisabeth Tully

1. INTRODUCTORY OSTEOLOGY

1.1. Define the anatomical position

1.2. Define the following terms of position and direction which are related to thestandardised anatomical positions:1.2.1. median (midsagittal) plane1.2.2. sagittal plane1.2.3. coronal (frontal) plane1.2.4. horizontal (transverse) plane1.2.5. anterior; posterior (ventral; dorsal)1.2.6. superior; inferior (rostral/cephalic; caudal)1.2.7. medial; lateral1.2.8. proximal; distal1.2.9. superficial; deep1.2.10. palmar; dorsal1.2.11. plantar; dorsal

1.3. Classify bones according to shape and give an example of each type.1.3.1. Long1.3.2. Short(cuboid)1.3.3. Flat1.3.4. Irregular1.3.5. Sesamoid

1.4. Draw a typical long bone and Illustrate the following features:1.4.1. diaphysis1.4.2. metaphysis1.4.3. epiphysis1.4.4. articular surfaces

1.5. Describe and state the functions of bony markings and find an example ofeach type of marking.1.5.1. Condyle1.5.2. Crest1.5.3. Epicondyle1.5.4. Process1.5.5. Line1.5.6. Lamina1.5.7. Spine

1.5.8. Tuberosity1.5.9. Trochanter1.5.10. Trochlear1.5.11. Facet1.5.12. Canal1.5.13. Fissure1.5.14. Foramen

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University of MelbourneDoctor of PhysiotherapyIndependent Learning Package in Functional AnatomyDr Doa El-Ansary and Dr Elisabeth Tully

1.5.15. Groove1.5.16. Meatus1.5.17. Fossa1.5.18. Notch1.5.19. Sulcus

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University of MelbourneDoctor of PhysiotherapyIndependent Learning Package in Functional AnatomyDr Doa El-Ansary and Dr Elisabeth Tully

2. Introductory Arthrology1.6. Define a joint or articulation.

1.7. Describe the general structure and the relative amount of movementavailable at each of the following types of joints, and give an example:

1.7.1. fibrocartilaginous1.7.2. hyaline and fibrocartilaginous1.7.3. synovial1.7.4.

1.8. Classify synovial joints, and give an example, according to:1.8.1. structure1.8.2. hinge1.8.3. pivot1.8.4. ellipsoid1.8.5. condyloid1.8.6. saddle1.8.7. ball & socket (plane/gliding)

1.8.8. degrees of freedom1.8.9. uniaxial1.8.10. biaxial1.8.11. multiaxial

1.8.12. complexity of organisation (shape of articular surfaces,number of mating pairs).

1.9. Describe 3 principal axes of motion about synovial joints.1.9.1.1.9.2.1.9.3.

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University of MelbourneDoctor of PhysiotherapyIndependent Learning Package in Functional AnatomyDr Doa El-Ansary and Dr Elisabeth Tully

1.10. Define and demonstrate the following types of movement aboutsynovial joints:1.10.1. active1.10.2. passive (physiological; accessory)

1.11. Define the following terms with respect to the ways in which articularsurfaces move in relation to each other1.11.1. spin1.11.2. roll1.11.3. glide

1.12. Describe the characteristics of the "close-packed" position of a joint.

1.13. List the anatomical features which can limit movement at a joint.

Quiz Questions

¾ Discuss the advantages and disadvantages of the types of jointclassification schemes.

¾ Define and list the functions of: bursae, discs, ligaments

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University of MelbourneDoctor of PhysiotherapyIndependent Learning Package - AnatomyDr Doa El-Ansary and Dr Elisabeth Tully

THE UNIVERSITY OF MELBOURNE

DEPARTMENT OF PHYSIOTHERAPYIndependent Learning Guide

PHYS@TOMYFOR

Doctor of Physiotherapy(Module 2: Shoulder, Upper Arm and Elbow)

Dr Doà El-Ansary, BAppSc(Phty), PhD

Dr Elizabeth Tully, BAppSc(Phty), Dip Ed, PhD

Page 12: Physio anatomy.pdf

University of MelbourneDoctor of PhysiotherapyIndependent Learning Package in Functional AnatomyDr Doa El-Ansary and Dr Elizabeth Tully

Introduction:Welcome to the Doctor of Physiotherapy Program. Phys@tomy is a self directed learningpackage that has been developed to facilitate student revision and preparation for entry intothe Doctor of Physiotherapy Program at the University of Melbourne.The material outlined in this package will form the basis of the theoretical background inFunctional Anatomy that will be in part assumed knowledge and will be built uponthroughout the graduate program. The material will be presented in a series of moduleseach of which will have detailed learning objectives that are designed to direct and sequencethe learning.It is advised that the student complete each module one at a time prior to moving onto thenext. It is recommended that the student take approximately 4 hours to complete eachmodule.

Modules:

Module 1: Introductory Osteology and ArthrologyModule 2: The Shoulder, Upper Arm and ElbowModule 3: The Forearm, Wrist and HandModule 4: Nerve and Blood Supply of the Upper LimbModule 5: The Hip and KneeModule 6: The Lower Leg and FootModule 7: The Nerve and Blood Supply to the Lower LimbModule 8: The Head and NeckModule 9: The TrunkModule 10: The Heart and Lungs

Learning ObjectivesMaterial in:

x bold print: form the structures that require identification. An anatomical atlas ormodel may be used for this purpose

x regular print: form the independent learning questions to be answered from the

recommended texts and lectures provided

x italic blue print: form the quiz questions that are aiming to extend knowledge into

application

x bold orange print: form the surface anatomy objectives

Page 13: Physio anatomy.pdf

University of MelbourneDoctor of PhysiotherapyIndependent Learning Package in Functional AnatomyDr Doa El-Ansary and Dr Elizabeth Tully

REFERENCESHighly recommended resources to guide your completion of each module:

x Textbook: Moore KL (2006) Clinically Orientated Anatomy (5th ed.) Baltimore:

Lippincott Williams & Wilkins*.

x Atlas: Rohen J, Yokochi C, Lutjen-Drecoll E (2002) Color Atlas of Anatomy: A

Photographic Study of the Human Body. Lippincott, Williams & Wilkins*

x Web based Materials: Eizenberg N, Briggs C, Barker P & Grkovic I(2010)An@tomedia CD-ROMs: (Available from University Bookshop and alsoavailable to all students on the computers in the Department of Physiotherapy

computer laboratory) *

Additional references for anatomyIn addition other resources that would be appropriate for completion of these modules are:

x Netter FH (2006) Atlas of Human Anatomy (4th ed. (Elsevier)

x Agur A, Dalley F (eds) (2005) Grant's Atlas of Anatomy (12th ed.) Philadelphia :Lippincott Williams & Wilkins

x Schuenke M, Schulte E, Schumacher U (Ross LM & Lamperti ED Consulting eds).

(2006). Thieme. Atlas of Anatomy: General anatomy and musculoskeletalsystem. Stuttgart, Thieme Publisher

x Oatis CA (2009) Kinesiology: The mechanics and Pathomechanics of human

movement. 2nd ed*x Levangie, P. K. and C. Norkin (2005). Joint Structure and Function:

A Comprehensive Analysis (4th ed). Philadelphia, F.A.Davis.x Neumann, D. (2002). Kinesiology of the Musculoskeletal System. Foundations for

Rehabilitation. St. Louis, Mosbyx Bogduk (2008) Clinical Anatomy of the Lumbar spine & Sacrum (6th Edn). Churchill

Livingstone.

Page 14: Physio anatomy.pdf

University of MelbourneDoctor of PhysiotherapyIndependent Learning Package in Functional AnatomyDr Doa El-Ansary and Dr Elizabeth Tully

BONES, JOINTS, MUSCLES OF THE SHOULDER

1.1 Identify and classify the bones of the shoulder girdle; clavicle and scapula.

1.2 On the clavicle identify:

(i) sternal end(ii) acromial end(iii) impression for the costoclavicular ligament(iv) trapezoid line(v) conoid tubercle

1.3 Identify the jugular notch/interclavicular notch between clavicles.

1.4 On the scapula (shown below) identify:

(i) dorsal surface(ii) costal surface(iii) superior, inferior, lateral borders(iv) superior, inferior, lateral angles(v) spine(vi) acromion and coracoid processes(vii) subscapular, supraspinous, infraspinous fossae(viii) glenoid fossa(ix) suprascapular notch(x) supraglenoid and infraglenoid tubercles

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University of MelbourneDoctor of PhysiotherapyIndependent Learning Package in Functional AnatomyDr Doa El-Ansary and Dr Elizabeth Tully

1.5 On the humerus identify:

(i) proximal end- head- anatomical and surgical necks- greater and lesser tubercles- bicipital (intertubercular) groove- medial and lateral lips of bicipital groove

(ii) shaft- medial,lateral and posterior surfaces- (spiral) groove for radial nerve

(iii) distal end- lateral and medial supracondylar ridges- lateral and medial epicondyles- capitulum- trochlea- olecranon, coronoid and radial fossae

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University of MelbourneDoctor of PhysiotherapyIndependent Learning Package in Functional AnatomyDr Doa El-Ansary and Dr Elizabeth Tully

1.6 Identify and classify the joints of the shoulder girdle:

(i) glenohumeral(ii) sternoclavicular joint(ii) acromioclavicular joint

1.7 At the acromioclavicular joint identify its:

(i) articular surfaces(ii) joint capsule

Page 17: Physio anatomy.pdf

University of MelbourneDoctor of PhysiotherapyIndependent Learning Package in Functional AnatomyDr Doa El-Ansary and Dr Elizabeth Tully

(ii) coracoclavicular ligament (conoid and trapezoid parts)

1.8 Describe the arrangement of bursae in the shoulder region. What is their function?

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University of MelbourneDoctor of PhysiotherapyIndependent Learning Package in Functional AnatomyDr Doa El-Ansary and Dr Elizabeth Tully

1.9 Describe the attachments and state the nerve supply of the followingmuscles

�PXVFOHV�FRQQHFWLQJ�WKH�D[LDO�VNHOHWRQ�DQG�WKH�KXPHUXV�Muscle Origin Insertion Nerve supplyPectoralis major-(sternal head)

Latissimus dorsi

�PXVFOHV�FRQQHFWLQJ�WKH�D[LDO�VNHOHWRQ�DQG�WKH�VKRXOGHU�JLUGOH�Muscle Origin Insertion Nerve supplyTrapezius

Rhomboid major

Rhomboid minor

Levator scapulae

Pectoralis minor

Serratus anterior

Subclavius

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University of MelbourneDoctor of PhysiotherapyIndependent Learning Package in Functional AnatomyDr Doa El-Ansary and Dr Elizabeth Tully

�PXVFOHV�FRQQHFWLQJ�WKH�VKRXOGHU�JLUGOH�DQG�WKH�KXPHUXV�

Muscle Origin Insertion Action Functionalactivity

Pectoralis major-(clavicular head)

Deltoid

Coracobrachialis

Teres major

Teres minor

Subscapularis

Supraspinatus

Infraspinatus

.

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University of MelbourneDoctor of PhysiotherapyIndependent Learning Package in Functional AnatomyDr Doa El-Ansary and Dr Elizabeth Tully

1.10. Name the muscles labelled 1, 2, & 3 below in figure 1

)LJ���,PDJH��+DQVHQ�-7�1HWWHU¶V�IODVK�FDUGV

1.11 (a) Name the structures labelled 1- 8 in figure 2a below.

(b) Identify and label the component parts of the capsuloligamentous complex on

Figure 2b

(c) State 3 functions of the glenoid labrum

(d) State the functions of the coracohumeral and transverse ligaments

1

3\

2

4

Page 21: Physio anatomy.pdf

University of MelbourneDoctor of PhysiotherapyIndependent Learning Package in Functional AnatomyDr Doa El-Ansary and Dr Elizabeth Tully

Figure 2a Figure 2b

1.12. (a) Identify the shoulder muscles shown in figures 3a and 3b below

,PDJHV��+DQVHQ�-7�1HWWHU¶V�IODVK�FDUGV

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University of MelbourneDoctor of PhysiotherapyIndependent Learning Package in Functional AnatomyDr Doa El-Ansary and Dr Elizabeth Tully

1.13. (a) Identify the muscles labelled 1 - 4 on the figure below

(b) State the nerve supply to these muscles

,PDJH��+DQVHQ�-7�1HWWHU¶V�IODVK�FDUGV�

2

3

4

Page 23: Physio anatomy.pdf

University of MelbourneDoctor of PhysiotherapyIndependent Learning Package in Functional AnatomyDr Doa El-Ansary and Dr Elizabeth Tully

Image: Hansen JT NetWHU¶V�IODVK�FDUGV�

Figure A

Figure B

Page 24: Physio anatomy.pdf

University of MelbourneDoctor of PhysiotherapyIndependent Learning Package in Functional AnatomyDr Doa El-Ansary and Dr Elizabeth Tully

1.14 Identify the nerves labelled 1-6 on Figure A, and 1-9 on Figure B, state their root valuesTHE SCAPULA1.14. For the healthy shoulder,

a Describe the posture of the scapula on the thoracic wall with reference to adjacent

bony landmarks

b Describe the orientation of the glenoid cavity in the erect position

1.12 (a) Use table form (as shown below) to list all muscles attached to the scapula and their

actions

Muscle UR DR El Dep Pro Ret

E.g. Upper trapezius X X X

(b) Indicate the attachments of these muscles on the diagrams below

Page 25: Physio anatomy.pdf

University of MelbourneDoctor of PhysiotherapyIndependent Learning Package in Functional AnatomyDr Doa El-Ansary and Dr Elizabeth Tully

Images: Thieme 2006

1.13.

(a) Describe changes in scapulo humeral

rhythm during arm elevation

(b) State the advantages of upward

rotation

(c) Name the muscles that are antagonist

to scapula upward rotation

(d) How may increased thoracic kyphosis

affect arm elevation?

Page 26: Physio anatomy.pdf

University of MelbourneDoctor of PhysiotherapyIndependent Learning Package in Functional AnatomyDr Doa El-Ansary and Dr Elizabeth Tully

1.14 Scapula Movements: Name the movements of the scapula on the diagrams above

THE CLAVICLE

1.15 For the sterno clavicular joint, describe

(a) shape of the articulating surfaces.

(b) role of the disc in the joint.

(c) joint movement ( in terms of rolls, slides and spin) during

Page 27: Physio anatomy.pdf

University of MelbourneDoctor of PhysiotherapyIndependent Learning Package in Functional AnatomyDr Doa El-Ansary and Dr Elizabeth Tully

the following shoulder girdle movements

x elevation and depression

x protraction and retraction

x posterior rotation of the clavicle

(d) What is the approximate range of each of these movements of the clavicle?

Page 28: Physio anatomy.pdf

University of MelbourneDoctor of PhysiotherapyIndependent Learning Package in Functional AnatomyDr Doa El-Ansary and Dr Elizabeth Tully

BONES, JOINTS AND MUSCLES OF THE ELBOW REGION

2.1 On the ulna identify:

(i) proximal end

- olecranon and coronoid processes- trochlear and radial notches- supinator fossa- ulnar tuberosity

(ii) shaft

- interosseus border- surfaces (medial,anterolateral,posterolateral)

(iii) distal end

- head- styloid process

2.2 On the radius identify:

(i) proximal end

- head- neck- radial tuberosity

(ii) shaft

- interosseus border- surface (lateral, anteromedial, posterolateral)- impression for pronator teres

(iii) distal end

Page 29: Physio anatomy.pdf

University of MelbourneDoctor of PhysiotherapyIndependent Learning Package in Functional AnatomyDr Doa El-Ansary and Dr Elizabeth Tully

- styloid process- ulnar notch- carpal (inferior) articular surface

2.3 Classify the elbow joint and identify and describe its:

(i) articular(ii) joint capsule and synovial membrane(iii) ligaments and their specific functions

- medial (ulnar collateral)- lateral (radial collateral)- anular

(iv) subcutaneous bursae and fat pads

Page 30: Physio anatomy.pdf

University of MelbourneDoctor of PhysiotherapyIndependent Learning Package in Functional AnatomyDr Doa El-Ansary and Dr Elizabeth Tully

2.4 Identify and classify the radio-ulnar joints:

(i) superior (proximal)(ii) inferior (distal)

2.5 At the proximal radio-ulnar joint identify and describe its:

(i) articular surfaces(ii) joint capsule(iii) anular ligament and its specific mechanical functions

2.6 At the distal radio-ulnar joint identify and describe its:

Page 31: Physio anatomy.pdf

University of MelbourneDoctor of PhysiotherapyIndependent Learning Package in Functional AnatomyDr Doa El-Ansary and Dr Elizabeth Tully

(i) articular surfaces(ii) joint capsule(iii) articular disc

2.7 Identify the interosseus membrane (intermediate radio-ulnar joint) and list itsfunctions.

2.8 Define, demonstrate and analyse movements at the elbow joint and the radioulnarjoints.

Movement Description Functional activity

2.9 State the close-packed position of the elbow and radioulnar joints.

2.10 Describe the "carrying angle" of the forearm.

Page 32: Physio anatomy.pdf

University of MelbourneDoctor of PhysiotherapyIndependent Learning Package in Functional AnatomyDr Doa El-Ansary and Dr Elizabeth Tully

2.11 Identify, describe the attachments and deduce the actions of thefollowing muscles:

Muscle Origin Insertion Action Functionalactivity

Biceps brachii

Brachialis

Brachioradialis

Triceps brachii

Anconeus

Pronator teres

Pronatorquadratus

Supinator

2.12 List the factors responsible for maintaining stability at the:

(i) elbow joint(ii) superior radioulnar joint(iii) inferior radioulnar joint

Page 33: Physio anatomy.pdf

University of MelbourneDoctor of PhysiotherapyIndependent Learning Package in Functional AnatomyDr Doa El-Ansary and Dr Elizabeth Tully

Surface Anatomy

2.13 Demonstrate on a living subject the principle bony features of the shoulderregion: (remember consent first)

� scapula- acromion- spine-T3- vertebral border- inferior-T7- coracoid process: press firmly upwards and laterally into the junction

of the middle and lateral thirds of the clavicle

� clavicle- sternal end: bulbous- acromial end: flattened

� humerus- head- greater tubercle: most lateral part covered by deltoid- deltoid tuberosity- medial and lateral epicondyles- medial and lateral supracondylar ridges

� sternoclavicular joint

� acromioclavicular joint

Page 34: Physio anatomy.pdf

University of MelbourneDoctor of PhysiotherapyIndependent Learning Package in Functional AnatomyDr Doa El-Ansary and Dr Elizabeth Tully

9.25 Observe and palpate the following muscles of the axilla and scapula regionsin a relaxed and contracted state

(i) trapezius(ii) serratus anterior(iii) latissimus dorsi-posterior axillary fold(iv) teres major(vi) pectoralis major-anterior fold(vii) deltoid(viii) infraspinatus(ix) tendons of the rotator cuff muscles

Page 35: Physio anatomy.pdf

University of MelbourneDoctor of PhysiotherapyIndependent Learning Package in Functional AnatomyDr Doa El-Ansary and Dr Elizabeth Tully

Page 36: Physio anatomy.pdf

University of MelbourneDoctor of PhysiotherapyIndependent Learning Package in Functional AnatomyDr Doa El-Ansary and Dr Elizabeth Tully

Quiz Questions

(1). The shoulder joint is designed for mobility.Describe the contribution of the following structural features to mobility at the

glenohumeral joint.(a) bony design(b) bony congruence(c) glenoid labrum(c) capsule(d) capsular ligaments

(2). 1DPH�WKH�URWDWRU�FXII�PXVFOHV�DQG�H[SODLQ�KRZ�WKH�URWDWRU�FXII�PXVFOHV�DFW�LQ�D�µIRUFH�

FRXSOH¶�ZLWK� deltoid as the arm is raised into full elevation via abduction. Use a diagram toaid you answer.

(i.e. bony architecture, passive structures (ligaments etc.), and dynamic structures(muscles etc.)

(3). Define the following terms relating to muscle function:

(i) spurt(ii) shunt

Give examples of each of these at the shoulder and the elbow joints.

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1

University of MelbourneDoctor of PhysiotherapyIndependent Learning Package - AnatomyDr Doa El-Ansary and Dr Elizabeth Tully

THE UNIVERSITY OF MELBOURNE

DEPARTMENT OF PHYSIOTHERAPY

PHYS@TOMYFOR

Doctor of Physiotherapy2010

(Module 3: The Forearm, Wrist and Hand)

Dr Doà El-Ansary, BAppSc(Phty), PhDDr Elizabeth Tully, BAppSc(Phty), Dip Ed, PhD

Page 38: Physio anatomy.pdf

2

University of MelbourneDoctor of PhysiotherapyIndependent Learning Package - AnatomyDr Doa El-Ansary and Dr Elizabeth Tully

Introduction:Welcome to the Doctor of Physiotherapy Program. Phys@tomy is a self directedlearning package that has been developed to facilitate student revision andpreparation for entry into the Doctor of Physiotherapy Program at the Universityof Melbourne.The material outlined in this package will form the basis of the theoreticalbackground in Functional Anatomy that will be in part assumed knowledge andwill be built upon throughout the graduate program. The material will bepresented in a series of modules each of which will have detailed learningobjectives that are designed to direct and sequence the learning.It is advised that the student complete each module one at a time prior to movingonto the next. It is recommended that the student take approximately 4 hours tocomplete each module.

Modules:

Module 1: Introductory Osteology and ArthrologyModule 2: The Shoulder, Upper Arm and ElbowModule 3: The Forearm, Wrist and HandModule 4: Nerve and Blood Supply of the Upper LimbModule 5: The Hip and KneeModule 6: The Lower Leg and FootModule 7: The Nerve and Blood Supply to the Lower LimbModule 8: The Head and NeckModule 9: The TrunkModule 10: The Heart and Lungs

Learning ObjectivesMaterial in:

x bold print: form the structures that require identification. Ananatomical atlas or model may be used for this purpose

x regular print: form the independent learning questions to be answered from

the recommended texts and lectures provided

x italic blue print: form the quiz questions that are aiming to extend

knowledge into application

x bold orange print: form the surface anatomy objectives

REFERENCESHighly recommended resources to guide your completion of each module:

x Textbook: Moore KL (2006) Clinically Orientated Anatomy (5th ed.)

Baltimore: Lippincott Williams & Wilkins*.

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University of MelbourneDoctor of PhysiotherapyIndependent Learning Package - AnatomyDr Doa El-Ansary and Dr Elizabeth Tully

REFERENCES

Recommended References for anatomyAny good anatomy textbook /atlas would be appropriate for completion of thesemodules. In the past many students have found the following anatomy texts to beuseful:

x Moore KL (2006) Clinically Orientated Anatomy (5th ed.) Baltimore:Lippincott Williams & Wilkins.

x Netter FH (2006) Atlas of Human Anatomy (4th ed. (Elsevier)

x Agur A, Dalley F (eds) (2005) Grant's Atlas of Anatomy (12th ed.)Philadelphia : Lippincott Williams & Wilkins

x Rohen J, Yokochi C, Lutjen-Drecoll E (2002) Color Atlas of Anatomy: APhotographic Study of the Human Body. Lippincott, Williams & Wilkins

x Schuenke M, Schulte E, Schumacher U (Ross LM & Lamperti ED Consulting

eds). (2006). Thieme. Atlas of Anatomy: General anatomy andmusculoskeletal system. Stuttgart, Thieme Publisher

Web based Materials:

x Eizenberg N, Briggs C, Barker P & Grkovic I (2010)An@tomedia CD-ROMs:(Available from University Bookshop and also available to all students onthe computers in the Department of Physiotherapy computer laboratory)

Recommended References for applied anatomy:

x Oatis CA (2009) Kinesiology: The mechanics and Pathomechanics ofhuman movement. 2nd ed

x Levangie, P. K. and C. Norkin (2005). Joint Structure and Function:A Comprehensive Analysis (4th ed). Philadelphia, F.A.Davis.

x Neumann, D. (2002). Kinesiology of the Musculoskeletal System.Foundations for Rehabilitation. St. Louis, Mosby

x Bogduk (2008) Clinical Anatomy of the Lumbar spine & Sacrum (6th Edn).

Churchill Livingstone.

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University of MelbourneDoctor of PhysiotherapyIndependent Learning Package - AnatomyDr Doa El-Ansary and Dr Elizabeth Tully

1. THE WRIST JOINT AND JOINTS OF THE HAND

1.1 Identify the bony groups in the articulated hand:

(i) 8 carpals(ii) 5 metacarpals(iii) 14 phalanges(iv) 2 sesamoid bones (radiographs)

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University of MelbourneDoctor of PhysiotherapyIndependent Learning Package - AnatomyDr Doa El-Ansary and Dr Elizabeth Tully

1.2 Identify the individual carpal bones and some features of thesecarpal bones, on the articulated hand:

(i) scaphoid and its tubercle )(ii) lunate ) proximal row(iii) triqetrium )(iv) pisiform )

(v) trapezium and its tubercle )(vi) trapezoid ) distal row(vii) capitate )(viii) hamate and its hook )

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University of MelbourneDoctor of PhysiotherapyIndependent Learning Package - AnatomyDr Doa El-Ansary and Dr Elizabeth Tully

1.3 On the metacarpals identify

- base- shaft- head

1.4 Identify proximal, middle and distal phalanges and on each phalanxidentify:

- base- shaft- head

1.5 Describe the axis of the hand and state the function of the axial line inregard to force transmission.

1.6 Classify the wrist (radiocarpal) joint and describe its:

(i) articular surfaces(ii) joint capsule(iii) articular disc(iv) ligaments

- palmar and dorsal radiocarpal- radial and ulnar collateral

1.7 Describe and demonstrate movements at the wrist joint.

Movement Description Functional activity

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University of MelbourneDoctor of PhysiotherapyIndependent Learning Package - AnatomyDr Doa El-Ansary and Dr Elizabeth Tully

1.8 State the close-packed position of the wrist joint.

1.9 Identify, classify, describe and demonstrate the movements at thefollowing joints of the hand:

Movement Description Functional activity

Midcarpal

Movements:

carpometacarpal

of thumb

movements:

carpometacarpal

of other digits

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University of MelbourneDoctor of PhysiotherapyIndependent Learning Package - AnatomyDr Doa El-Ansary and Dr Elizabeth Tully

1.10 State the contributions of midcarpal and radiocarpal joints to movements ofthe hand.

1.11 Identify, classify and describe certain features of the joints of thefingers:

�PHWDFDUSRSKDODQJHDO

(i) articular surfaces(ii) ligaments and their functions

- collateral- palmar- deep transverse metacarpal- extensor aponeurosis

(iii) movements(iv) sesamoid bones of the thumb and their functions

�LQWHUSKDODQJHDO

(i) articular surfaces(ii) ligaments and their functions

- collateral- extensor aponeurosis- palmar

(iii) movements

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University of MelbourneDoctor of PhysiotherapyIndependent Learning Package - AnatomyDr Doa El-Ansary and Dr Elizabeth Tully

2. MUSCLES OF THE FOREARM AND HAND

2.1 Identify, describe the attachments and deduce the action(s) of themuscles of the forearm:

�IOH[RU��DQWHURPHGLDO��JURXS�

Muscle Origin Insertion Action Functionalactivity

Superficial layerPronator teres

Flexor carpiradialis

Palmar longus

Flexor digitorumsuperficialis

Flexor carpi ulnaris

Deep layerFlexor digitorumprofundus

Flexor pollicislongus

Pronatorquadratus

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University of MelbourneDoctor of PhysiotherapyIndependent Learning Package - AnatomyDr Doa El-Ansary and Dr Elizabeth Tully

�H[WHQVRU��SRVWHUROateral) group:

Muscle Origin Insertion Action Functionalactivity

Superficial layerBrachioradialis

Extensor carpiradialis longus

Extensor carpiradialis brevis

Extensor digitorum

Extensor digitiminimi

Extensor carpiulnaris

Anconeus

Deep layerSupinator

Abductor pollicislongus

Extensor pollicisbrevis

Extensor indicis

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University of MelbourneDoctor of PhysiotherapyIndependent Learning Package - AnatomyDr Doa El-Ansary and Dr Elizabeth Tully

2.2 Identify the flexor and extensor retincula and state the function(s) ofretincula.

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University of MelbourneDoctor of PhysiotherapyIndependent Learning Package - AnatomyDr Doa El-Ansary and Dr Elizabeth Tully

2.3 Identify, describe the attachments and deduce the actions of theintrinsic muscles of the hand:

Muscle Origin Insertion Action Functionalactivity

flexor pollicisbrevis

thenar eminenceabductor pollicisbrevis

opponens pollicis

hypothenareminenceflexor digiti minimi

abductor digitiminimi

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University of MelbourneDoctor of PhysiotherapyIndependent Learning Package - AnatomyDr Doa El-Ansary and Dr Elizabeth Tully

opponens digitiminimi

Other Intrinsicsadductor pollicis

lumbricals

dorsal interossei

palmar interossei

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University of MelbourneDoctor of PhysiotherapyIndependent Learning Package - AnatomyDr Doa El-Ansary and Dr Elizabeth Tully

Anterior View Anterior ViewSuperficial forearm muscles Deep forearm muscles

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University of MelbourneDoctor of PhysiotherapyIndependent Learning Package - AnatomyDr Doa El-Ansary and Dr Elizabeth Tully

Posterior View Posterior ViewSuperficial forearm muscles Deep forearm muscles.

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University of MelbourneDoctor of PhysiotherapyIndependent Learning Package - AnatomyDr Doa El-Ansary and Dr Elizabeth Tully

2.4 Identify and describe the extent, and describe the function(s) of:

(i) palmar aponeurosis(ii) intertendinous connections(iii) synovial sheaths(iv) extensor aponeurosis

2.5 Define the position of function of the hand.

2.6 Describe the role of the interossei and lumbricals in producing normal digitalsweep.

SURFACE ANATOMY OF THE ARM, FOREARM AND HAND

2.7 Demonstrate on a living subject:

�WKH�SULQFLSDO�ERQ\�IHDWXUHV�RI�WKH�IRUHDUP�

(i) ulnar- olecranon process- posterior borders-intervenes between the two functional

groups of the muscles of the forearm.- head- styloid process-best felt when the forearm is pronated

(ii) radius- head- styloid process

� the following muscles and tendons of the arm and forearm:

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University of MelbourneDoctor of PhysiotherapyIndependent Learning Package - AnatomyDr Doa El-Ansary and Dr Elizabeth Tully

(i) biceps brachii(ii) triceps brachii(ii) anconeus

- this is a triangular muscle whose angles are formed by theolecranon process, lateral epicondyle, and a point on theposterior border of the ulna about 10cm distal to theolecranon process

(iii) brachioradialis(iv) cubital fossa(v) extensor compartment (group) of the forearm(vi) flexor compartment (group) of the forearm(vii) tendons of the following muscles on the anterior aspect of the

wrist:- flexor carpi radialis- palmaris longus- flexor digitorum superficialis- flexor carpi ulnaris

(ix) extensor carpi radialis longus(x) extensor carpi radialis brevis

� all the carpal bones and some of their features

(i) hook of hamate- can be felt by deep pressure in the hypothenar eminence,

distal to the pisiform and closer to the centre of the palm

(ii) tubercle of the scaphoid- at the proximal edge of the thenar eminence, adjacent tothe distal crease of the wrist

� the following muscles and tendons of the hand:

(i) tendons of extensor digitorum(ii) the "anatomical snuff box" (evident when the thumb is

extended) bounded by the tendons of:- extensor pollicis longus- extensor pollicis brevis- abductor pollicis longus

(iii) thenar and hypothenar eminence(iv) 1st dorsal interosseus muscle

� the relative mobility of the metacarpals and list them indecreasing order of mobility.

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University of MelbourneDoctor of PhysiotherapyIndependent Learning Package - AnatomyDr Doa El-Ansary and Dr Elizabeth Tully

2.8 Draw a pattern of the hand, and on it draw the palmar creases. Relatethe following creases of the hand to the underlying joints on yourdrawing:

(i) creases of the wrist:- proximal- middle- distal

(ii) creases of the palm:- longitudinal palmar ("life line")- middle palmar ("destiny line")- proximal transverse ("head line")- distal transverse ("heart line")

(iii) creases of the digits:- proximal- middle- distal

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University of MelbourneDoctor of PhysiotherapyIndependent Learning Package - AnatomyDr Doa El-Ansary and Dr Elizabeth Tully

Quiz Questions

1. Demonstrate different types of precision and power grips and discuss thedifferences in terms of:

(i) the muscles involved(ii) the position of the wrist and hand

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University of MelbourneDoctor of PhysiotherapyIndependent Learning Package - AnatomyDr Doa El-Ansary and Dr Elizabeth Tully

THE UNIVERSITY OF MELBOURNE

DEPARTMENT OF PHYSIOTHERAPYIndependent Learning Guide

PHYS@TOMYFOR

Doctor of Physiotherapy(Module 4: The Nerve and Blood Supply of the Upper Limb)

Dr Doà El-Ansary, BAppSc(Phty), PhD

Dr Elizabeth Tully, BAppSc(Phty), Dip Ed, PhD

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University of MelbourneDoctor of PhysiotherapyIndependent Learning Package - AnatomyDr Doa El-Ansary and Dr Elizabeth Tully

Introduction:Welcome to the Doctor of Physiotherapy Program. Phys@tomy is a self directedlearning package that has been developed to facilitate student revision andpreparation for entry into the Doctor of Physiotherapy Program at the University ofMelbourne.The material outlined in this package will form the basis of the theoreticalbackground in Functional Anatomy that will be in part assumed knowledge and willbe built upon throughout the graduate program. The material will be presented ina series of modules each of which will have detailed learning objectives that aredesigned to direct and sequence the learning.It is advised that the student complete each module one at a time prior to movingonto the next. It is recommended that the student take approximately 4 hours tocomplete each module.

Modules:

Module 1: Introductory Osteology and ArthrologyModule 2: The Shoulder, Upper Arm and ElbowModule 3: The Forearm, Wrist and HandModule 4: Nerve and Blood Supply of the Upper LimbModule 5: The Hip and KneeModule 6: The Lower Leg and FootModule 7: The Nerve and Blood Supply to the Lower LimbModule 8: The Head and NeckModule 9: The TrunkModule 10: The Heart and Lungs

Learning ObjectivesMaterial in:

x bold print: form the structures that require identification. An anatomicalatlas or model may be used for this purpose

x regular print: form the independent learning questions to be answered from

the recommended texts and lectures provided

x italic blue print: form the quiz questions that are aiming to extend knowledge

into application

x bold orange print: form the surface anatomy objectives

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University of MelbourneDoctor of PhysiotherapyIndependent Learning Package - AnatomyDr Doa El-Ansary and Dr Elizabeth Tully

REFERENCES

Highly recommended resources to guide your completion of each module:x Textbook: Moore KL (2006) Clinically Orientated Anatomy (5th ed.)

Baltimore: Lippincott Williams & Wilkins*.

x Atlas: Rohen J, Yokochi C, Lutjen-Drecoll E (2002) Color Atlas ofAnatomy: A Photographic Study of the Human Body. Lippincott, Williams &

Wilkins*

x Web based Materials: Eizenberg N, Briggs C, Barker P & Grkovic I(2010)An@tomedia CD-ROMs: (Available from University Bookshop and alsoavailable to all students on the computers in the Department of Physiotherapy

computer laboratory) *

Additional references for anatomyIn addition other resources that would be appropriate for completion of thesemodules are:

x Netter FH (2006) Atlas of Human Anatomy (4th ed. (Elsevier)

x Agur A, Dalley F (eds) (2005) Grant's Atlas of Anatomy (12th ed.)Philadelphia : Lippincott Williams & Wilkins

x Schuenke M, Schulte E, Schumacher U (Ross LM & Lamperti ED Consulting

eds). (2006). Thieme. Atlas of Anatomy: General anatomy andmusculoskeletal system. Stuttgart, Thieme Publisher

x Oatis CA (2009) Kinesiology: The mechanics and Pathomechanics of

human movement. 2nd ed*x Levangie, P. K. and C. Norkin (2005). Joint Structure and Function:

A Comprehensive Analysis (4th ed). Philadelphia, F.A.Davis.x Neumann, D. (2002). Kinesiology of the Musculoskeletal System.

Foundations for Rehabilitation. St. Louis, Mosbyx Bogduk (2008) Clinical Anatomy of the Lumbar spine & Sacrum (6th Edn).

Churchill Livingstone.

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University of MelbourneDoctor of PhysiotherapyIndependent Learning Package - AnatomyDr Doa El-Ansary and Dr Elizabeth Tully

NERVE SUPPLY TO THE UPPER LIMB

1.1 Describe the following features of the brachial plexus:

(i) its formation from ventral rami(ii) its trunks(iii) its division(iv) its cords(v) the position of each of the above in the shoulder region

1.2 Identify the following branches of the brachial plexus and state theirmotor distribution (the muscles each supplies):

(i) dorsal scapular(ii) long thoracic

(iii) suprascapular(iv) upper subscapular(v) lateral pectoral(vi) medial scapular(vii) thoracodorsal(viii) lower subscapular

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University of MelbourneDoctor of PhysiotherapyIndependent Learning Package - AnatomyDr Doa El-Ansary and Dr Elizabeth Tully

1.3 Identify the following sensory branches of the brachial plexus andstate the root value and distribution of each:

(i) medial cutaneous nerve of arm(ii) medial cutaneous of forearm

1.4 Identify the peripheral nerves of the brachial plexus:

(i) axillary (circumflex)(ii) radial and its posterior interosseus branch(iii) musculocutaneous(iv) median and its anterior interosseus branch(v) ulnar

1.5 For each of the peripheral nerves listed in 14.4:

(i) state its root value(ii) identify its course through the upper limb(iii) describe its sensory distribution(iv) describe its motor distribution

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University of MelbourneDoctor of PhysiotherapyIndependent Learning Package - AnatomyDr Doa El-Ansary and Dr Elizabeth Tully

1.6 Describe the innervation of the following joints:

(i) shoulder(ii) elbow(iii) wrist

and deduce a general rule for nerve supply to joints.

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University of MelbourneDoctor of PhysiotherapyIndependent Learning Package - AnatomyDr Doa El-Ansary and Dr Elizabeth Tully

ACTIVITIES AND QUIZ QUESTIONS:

1. Describe the functional motor loss and deformity resulting from a lesion to thefollowing nerves in the area indicated:

(i) radial nerve - in the axilla(ii) ulnar nerve - at the medial epicondyle of the humerus(iii) median nerve - at the wrist

2. Complete the following chart to summarise objective 14.5.

PERIPHERAL NERVES TO THE UPPER LIMB

PeripheralNerve

NerveRoot Value

MotorDistribution

SensoryDistribution

Medial cutaneousnerve of arm

Medial cutaneousof forearm

Axillary (circumflex

Radial and itsposteriorinterosseus branch

Musculocutaneous

Median and itsanteriorinterosseus branch

Ulnar

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University of MelbourneDoctor of PhysiotherapyIndependent Learning Package - AnatomyDr Doa El-Ansary and Dr Elizabeth Tully

3. Colour in the distribution of the cutaneous nerves on the dorsal and palmaraspects of the hand:

Palm Dorsum

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University of MelbourneDoctor of PhysiotherapyIndependent Learning Package - AnatomyDr Doa El-Ansary and Dr Elizabeth Tully

2. BLOOD SUPPLY TO THE UPPER LIMB

Objectives2.1Identify:

(i) ascending aorta(ii) arch of aorta(iii) descending thoracic aorta(iv) brachiocephalic artery )(v) L common carotid artery ) branches of aorta(vi) L subclavian artery )

(vii) R common carotid artery ) branches of brachiocephalic(viii) R subclavian artery ) artery

2.2 Briefly state the area of supply of the arteries listed in objective 15.1

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University of MelbourneDoctor of PhysiotherapyIndependent Learning Package - AnatomyDr Doa El-Ansary and Dr Elizabeth Tully

2.3 Identify and describe the course and general areas of supply of thearteries of the upper limb:

(i) axillary(ii) brachial(iii) profunda brachii(iv) radial(v) ulnar(vi) superficial palmar arch(vii)deep palmar arch

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University of MelbourneDoctor of PhysiotherapyIndependent Learning Package - AnatomyDr Doa El-Ansary and Dr Elizabeth Tully

2.4 Palpate the pulses of the upper limb at the following positions:

(i) subclavian artery - above medial end of the clavicle(ii) brachial artery - between the heads of biceps brachii (median bicipital

furrow) and at the cubital fossa(iii) radial artery - on the antero-lateral aspect of the wrist(iv) mark on the diagrams where you found them.

2.5Describe the arrangement of the veins of the upper limb into a superficial and adeep group and deduce the functional significance of this arrangement.

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University of MelbourneDoctor of PhysiotherapyIndependent Learning Package - AnatomyDr Doa El-Ansary and Dr Elizabeth Tully

2.6 Identify and describe the course opf the deep veins:

(i) radial(ii) ulnar(iii) brachial(iv) axillary

2.7 Identify and describe the course of the superficial veins of the upperlimb:

(i) dorsal venous arch(ii) palmar venous arch(iii) cephalic(iv) basilic(v) median antebrachial(vi)median cubital

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University of MelbourneDoctor of PhysiotherapyIndependent Learning Package - AnatomyDr Doa El-Ansary and Dr Elizabeth Tully

2.8 Identify the veins transporting blood from the upper limb to the heart:(i) subclavian(ii) brachiocephalic(iii) superior vena cava

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University of MelbourneDoctor of PhysiotherapyIndependent Learning Package - AnatomyDr Doa El-Ansary and Dr Elizabeth Tully

Final feedback questionnaireThank you for assisting in evaluation of the anatomy resources for students completing postgraduatestudies at the University of Melbourne.Please answer these statements by circling the appropriate response:

1. This guide has helped me identify theareas I needed to study

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5. The activities did not have enoughfunctional applications

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11. Other comments:

Please return to Dr Doà El-Ansary. Thank you!